31 July 2015

How I Manage my Pain | Freiberg's Disease

One of my biggest challenges over the past year and a half has been successfully managing the pain I go through daily living with Freiberg's Disease. 

Since my diagnosis, I have tried a wide variety of pain relief. Standard pain medication does little to nothing to manage my pain so following my consultation with a surgeon back in June 2014, I was admitted to hospital to undergo a procedure which involved an incredibly painful corticosteroid injection into my damaged third metatarsal joint. The injection was a failure, and what was supposed to provide temporary pain relief did nothing to improve or manage my condition. 

HEAT COMPRESSES / ICE PACKS

For weeks and months on end,  I could not sleep because of the dull crunching pain in my foot. I would apply warm compresses from time to time, which although did not take down any swelling around my joint, certainly worked in terms of soothing the muscles around the area. When I had a lot of uncomfortable swelling, I would use cold compresses but the pain would always be there. 


Right now I'm actually using a "therapy disc" hot AND cold compress I found in Boots the other day. This is a great little thing because you can either heat it up in a hot water bath or use it cold from your fridge or freezer. It came with a handy little cloth pouch so you don't get a heat / cold rash from direct contact and lasts about 15 minutes. Granted 15 minutes of heat / cold therapy is no where near enough to manage my pain - but it's easily heated / chilled down again for reuse. 


ELEVATION

When I can I try to elevate my legs, particularly when I am sitting at home writing blogs or watching tv. I find elevation helps prevent swelling in my foot and also takes pressure off my legs and hips helping any additional aches or pains. 

In addition, I also keep my foot elevated when I sleep. My husband finds my pillow fortress hilarious. I sleep with one pillow to the side which when I lie on my left side I place my right leg over and another pillow at the base of my feet just in case I move around. I generally keep my foot out of the covers because even the weight of the covers over my foot can be quite painful.

WALKING AID

I have been using walking aids for over a year now to help maintain the pain I endure when walking with my condition. I was under the care of physiotherapist who tried to construct an orthopaedic insole that would allow me walk as normal as possible. While they were adamant it would work, they underestimated the progression of my condition and as a result I was in agonising pain for days after anytime I attempted to walk in them for longer than 20 minutes in a day. In addition, the swelling and sensitivity of my foot makes it incredibly difficult for me to put on shoes. 

I started with a metatarsal support and two crutches. This seemed to work for a short period of time, but after almost 12 weeks of elevation and rest as well as a confirmed diagnosis of Stage IV Freibergs Disease, I was advised some form of a walking boot may help me get around a bit easier while keeping the joint immobilised so as not to cause further discomfort or damage. I got my first boot in May 2014. This made it much easier for me to walk around, do errands and venture further than my house. Granted I still needed breaks, and it did not improve my pain in the slightest but to be honest I was just happy to be able to get out of my house and not worry about being doubled over by pain within the first ten minutes of walking. 

By December 2014, one year after my initial injury I had worn through three walking boots. I also use a crutch in addition to the boot because although the idea of the boot is that you can walk as normally as possible, I often found the boots were quite slippy on certain surfaces. For that reason, the crutch became my only assurance of stability in the event that my footing failed me. Also, walking boots have a significant platform to help with shock absorption. This means that the left (unaffected) side of my body was significantly lower than my right. By using the crutch I also assure that I am putting less pressure on my damaged foot and therefore use my dominant side to control my walking. 

MEDICATION

Following the failure of my cortisone injection, I was prescribed an opiod analgesic drug. This drug is used to treat moderate to severe chronic pain. It works by targeting two different sets of pain receptors in the brain. It reduces the pain messages to the brain, while also boosting pain killing messages. It is also a slow release medication, meaning I can avail of up to twelve hours relief on good days. While this has been the best method I have tried for managing my pain so far, it also came with many side effects, most commonly including exhaustion and drowsiness. 


SLEEP

Taking this medication at night can either help me sleep or keep me wide awake, sometimes in a state of lucid dreaming so unfortunately my sleeping situation has not improved greatly. I often need naps through the day to help with my exhaustion. 

DIET

In addition to medication, I also try to maintain a healthy diet. I've found many times that binge eating junk food makes me feel sluggish and additionally more aware of my pain. I was both confused an interested by this so I done a little googling and came across several interesting facts about how our body manages pain when certain factors are added to our diet. For example, aspartame which is found in many diet sodas and sweeteners is actually part of a chemical group called exitotoxins which when consumed activate neurons associated with pain sensitivity. I found this incredibly interesting, especially since I am particularly fond of Coca Cola Zero, which for the past few months I have been subconsciously avoiding - opting for the standard sugary versions when the sweet too for mineral sodas gets the better of me. Is my body subconsciously aware that diet soda makes me more susceptible to my pain?

My journey to recovery has not even begun, but these are just some of the things I do to help me cope on a day to day basis. Have you ever suffered with a form of chronic pain? What did you do that you felt was invaluable to your comfort and / or recovery?

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